Novel human coronavirus infection
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
This is a new strain of coronavirus that has not been previously identified in humans.
Historical Perspective
The virus first emerged in the Middle East, and was discovered on September 2012 in a Qatari patient who had recently traveled to Saudi Arabia.[1] He is being treated for the respiratory disease, which has led to renal failure.[2] The first known case was a Saudi Arabian who died in early 2012. The World Health Organisation (WHO) announced that it is "engaged in further characterizing the novel coronavirus" and that it has "immediately alerted all its Member States about the virus and has been leading the coordination and providing guidance to health authorities and technical health agencies."[3] Virologist Ron Fouchier has speculated that the virus might originate from bats.[4]
Saudi Arabia's Ministry of Health was concerned that the virus might affect the October 2012 Hajj, the Islamic pilgrimage to Mecca, as Muslims making the Hajj may have been infected.[5]
Following the high-profile publicity of SARS outbreaks, there has been a renewed interest in coronaviruses in the field of virology. For many years, scientists knew only about the existence of two human coronaviruses (HCoV-229E and HCoV-OC43). The discovery of SARS-CoV added another human coronavirus to the list. By the end of 2004, three independent research labs reported the discovery of a fourth human coronavirus. It has been named NL63, NL or the New Haven coronavirus by the different research groups.[6] The naming of this fourth coronavirus is still a controversial issue, because the three labs are still battling over who actually discovered the virus first and hence earns the right to name the virus. Early in 2005, a research team at the University of Hong Kong reported finding a fifth human coronavirus in two pneumonia patients, and subsequently named it HKU1.
Classification
- HCoV-229E
- HCoV-OC43
- SARS-CoV
- NL63/NL/New Haven coronavirus
- HKU1-CoV
- HCoV-EMC
- Novel Coronavirus 2012
Pathophysiology
Transmission
- The cases occurring in the same family raises the possibility of limited human-to-human transmission. Alternatively, it is possible that the infected family members were exposed to the same source of infection, for example, in a household or workplace.
- There is currently no direct evidence that the human cases were exposed through direct contact with animals.
WHO recognizes that the emergence of a new coronavirus capable of causing severe disease raises concerns because of experience with SARS. Although this novel coronavirus is distantly related to the SARS CoV, they are different. Based on current information, it does not appear to transmit easily between people, unlike the SARS virus.
Epidemiology and Demographics
As of November 30, 2012, nine laboratory confirmed cases have been reported to WHO - five from Saudi Arabia, two from Qatar, and two from Jordan. The onset of illness was between April - November 2012. Among the nine cases, five were fatal. Based on available information, the clinical picture consists of febrile illness and pneumonia.[7]
Five cases were associated with two clusters. The first cluster of two cases, both fatal, occurred near Amman, Jordan, in April 2012. Stored samples from these two cases tested positive retrospectively for the novel coronavirus. This cluster was temporally associated with cases of illness among workers in a hospital. A second cluster occurred in October, 2012, in Saudi Arabia. Of the four individuals in the household, three were laboratory confirmed cases, two of them died.
United States
- There are no reports of anyone in United States getting infected and sick with the novel coronavirus. Risk of getting infected with this virus is estimated to be low.
- WHO and CDC have not issued any travel alerts for countries in the Arabian Peninsula or neighboring countries. Your risk of getting infected with the novel coronavirus while in these countries is estimated to be low.
Natural History, Complications and Prognosis
Complications
- Pericarditis [8]
- Renal failure
- DIC
- Severe respiratory failure
Diagnosis
History and Symptoms
In confirmed cases of illness in humans, common symptoms have been acute, serious respiratory illness with fever, cough, shortness of breath, and breathing difficulties. Based on current clinical experience, the infection generally presents as pneumonia. It has caused kidney failure and death in some cases. It is important to note that the current understanding of the illness caused by this infection is based on a limited number of cases and may change as more information becomes available.
Physical Examination
Vital Signs
- Temperature: Fever
Laboratory Findings
Other Diagnostic Studies
The United Kingdom's Health Protection Agency is working on the genetic sequence of the virus, based on the sequence obtained from the Qatari case.[9]
Treatment
Prevention
- There is no vaccine currently available.
External Links
References
- ↑ Nebehay, Stephanie (26 September 2012). "WHO issues guidance on new virus, gears up for haj". Reuters. Retrieved 27 September 2012.
- ↑ Falco, Miriam (24 September 2012). "New SARS-like virus poses medical mystery". CNN. Retrieved 27 September 2012.
- ↑ "Novel coronavirus infection". World Health Organisation. 25 September 2012. Retrieved 27 September 2012.
- ↑ Doucleff, Michaeleen (28 September 2012). "Holy Bat Virus! Genome Hints At Origin Of SARS-Like Virus". NPR. Retrieved 29 September 2012.
- ↑ Moisse, Katie (27 September 2012). "Saudi Health Officials Brace for Hajj Pilgrimage to Mecca". ABC News. Retrieved 27 September 2012.
- ↑ van der Hoek L, Pyrc K, Jebbink MF; et al. (2004). "Identification of a new human coronavirus". Nat Med. 10 (4): 368&ndash, 73. doi:10.1038/nm1024.
- ↑ "How threatening is the new coronavirus?". BBC. 24 September 2012. Retrieved 27 September 2012.